gms | German Medical Science

Objectives/Interrogation: Advanced Dupuytrens disease and other pathological conditions can lead to extreme contractures of fingers, which are technically hard to access by surgery. Thus, the effort and the chance of complications in operative treatment are increasing in relation to the level of contracture.

Hence preoperative treatment for those severe conditions, aiming to minimize extension deficit, is desirable.

In this concern, treatment is divided in invasive and non-invasive methods. Invasive treatment can be associated with severe complications and needs good compliance. Non-invasive, ready-to-use splints are useless for severe contractures. Only few technical devices and solutions are described in the literature, most of them are only available at one hospital and not on the European or global market.

We felt the necessity to obtain a non-invasive device, capable of mastering all desired requirements and linked with lowest drop out rate possible.

Methods: We developed a pneumatic splint, which addresses severe contractures of the fingers and is obtainable for everybody.

It is composed of a combination of a hard material splint, a steel frame clip and flexible materials. The splint has a hinge, which can be adjusted and fixed with a lever at any angle. The clip divides an air chamber, allowing to direct the expansion of the flexible materials in two different locations (thenar/hypothenar and fingers) from palmar to dorsal; the device is fixed at the dorsal side of the hand. The combination of the materials interact, thus realizing a stretching force to the fingers, according to the three-point support principle. The splint can be easily adapted and used with one hand and at both sides.

Results and Conclusions: The recently on the market available, innovative device is efficient particularly for the preoperative treatment of severe finger contractures, avoiding the disadvantages of invasive options. It is simple to use, variable and adaptive to even high grade contractures and thus effective, when other splints fail. The acting forces can be fine-tuned at any time and the splint therefore fulfills the need to act smoothly on the tissues. It provides patients with a magnitude of comfort, is very application friendly and highly accepted.